Teamwork, interchangeability and leadership needed in prepared hospitals
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There are important lessons the pandemic has taught about hospital preparedness, teamwork and leadership, opening the way to important positive changes, according to Marcel Levi, MD, PhD, FRCP.
As the pandemic spread across the globe, hospitals underwent fast and radical restructuring with massive redeployment of medical and nursing staff, a complex situation to which no one was prepared.
“When I look at hospital organization, I often think of the catenaccio tactics, very much in fashion in the football teams in the last century. It was a position-oriented football playing, where each one played from his own fixed position. It was effective but not very flexible, and this is how we have organized our hospitals so far,” Levi, a specialist in clinical immunology and acute medicine, consultant at University College London Hospital, said in his keynote address at the virtual European Society of Cataract and Refractive Surgeons meeting.
Today, medical staff are highly specialized and even subspecialized, and while the specialized approach has advantages, it does not help when interchangeability is required.
“When something like a pandemic touches you, you may be asked to do someone else’s job because that person might have to do something else as well. We are not very well prepared to do that in hospitals,” Levi said.
Back to football, catenaccio was later replaced by total football, in which an outfield player can take over the role of any other player on the team. This strategy, which helped several teams win the World Cup, is what hospitals need to reflect upon and adopt for the future.
Another important lesson learned during the pandemic was that the decisions in hospitals should be made by those who work on the front line.
At a time when a lot needed to be done at the same time, from organizing intensive care and emergency care to facing issues such as shortages of personal protective equipment and concerns about data safety, personal safety and testing, doctors and nurses were the professionals who had the answers, Levi said.
Managers and administrative staff are there to provide support, but health care professionals should take the lead.
“It is nothing to do with power, but with influence and responsibility. With professionals in the lead and managers in a supportive role, we can achieve the most fantastic things, much to the benefit of our patients and also to ourselves,” Levi said.
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Levi M. Tackling COVID-19 crisis: professionals in the lead. Presented at: European Society of Cataract and Refractive Surgeons meeting; Oct. 2-4, 2020 (virtual meeting).
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